Assessment of Cognitive Function After Surgery in Two Types of Anesthesia in Patients Operated for Breast Cancer

Not Applicable

Completed

Brief Summary: The emergence of cognitive disorders after surgery under general anesthesia (GA) is the second leading cause of patient complaints (after dental debris caused by intubation techniques). These cognitive disorders can range from simple reversible confusion (26%) with postoperative cognitive dysfunction without actual recovery (10%).

The hypnosedation is an ancient technique of anesthesia expanding its effects on cognitive function remain to this day unknown, but appear promising.

Detailed Description: For twenty years, hypnosedation is offered to patients who underwent surgery as an alternative to other anesthetic techniques (general anesthesia and locoregional), in some European and Anglo-Saxon hospitals for specific surgical indications (surgery area). It is commonly used in some hospitals.

The hypnosedation is little used in oncology

The hypnosedation is a hypnosis technique suitable for anesthesia, namely the one associated with intravenous conscious sedation and local anesthesia hypnosis. This derived from medical hypnosis Ericksoniene technique is divided into three stages:

1. induction

2. Deepening trance

3. Déhypnotisation.

This technique is currently being validated and used at national and international level, in fact it is based on 500 references and appears in the national nomenclature of the Common Classification of Medical Procedures in the code ANRP 001, states: hypnosis referred to analgesic.

Recruitment & Eligibility

Inclusion Criteria

Female, over 18 and under 80 years
Diagnosis of breast cancer established (Pathology)
Life expectancy greater than 6 months
Surgery of breast lumpectomy with or without lymph node dissection, mastectomy with or without lymph node dissection, dissection isolated
ASA 1 (healthy patient) or 2 (patient with moderate to high function) according to the classification of the American Society of Anesthesiologist,
Affiliation to a social security scheme,
Information on the study, signed informed consent

Exclusion Criteria

Presence of major psychiatric disorders or psychotic behavior addiction, evaluated by neuropsychologist at the first preoperative consultation, through the test MINI (MINI> 4 positive responses for each module)
Presence of neurological disorders known untreated or evaluated by neuropsychologist at the first preoperative consultation, with the MMSE test (MMSE <24)
Patient treated morphine orally for 3 months or more
Patient is pregnant or nursing, or of childbearing potential and not using adequate contraception,
Patient included in another clinical study
Inability to undergo medical monitoring study for geographical, social or psychological
Patient deprived of liberty and most subject to a measure of legal protection or unable to consent

Arm && Interventions

Group	Intervention	Description
hypnosedation	hypnosedation	hypnosedation
general anesthesia	general anesthésia	general anesthesia

Primary Outcome Measures

Name	Time	Method
Presence of Cognitive Impairment	on the 7th day following surgery	Cognitive impairment is assessed using the MMSE questionnaire (MINI-MENTAL STATE EXAMINATION). the MMSE total score ranges from 0 (alteration of cognition) to 30 (no alteration)

Secondary Outcome Measures

Name	Time	Method
Presence of Cognitive Impairment	1 month after surgery	Cognitive impairment is assessed using the MMSE questionnaire (MINI-MENTAL STATE EXAMINATION) The MMSE total score ranges from 0 (alteration of cognition) to 30 (no alteration)

Locations (3): Centre Paul Strauss
🇫🇷
Strasbourg, Alsace, France
Institut Bergonié
🇫🇷
Bordeaux, Aquitaine, France
Centre Oscar Lambret
🇫🇷
Lille, Nord, France